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学科主题: 公共卫生
题名:
Incidence, Clinical Features and Impact on Anti-Tuberculosis Treatment of Anti-Tuberculosis Drug Induced Liver Injury (ATLI) in China
作者: Shang, Penghui1; Xia, Yinyin2; Liu, Feiying3; Wang, Xiaomeng4; Yuan, Yanli5; Hu, Daiyu6; Tu, Dehua7; Chen, Yixin8; Deng, Peiyuan8; Cheng, Shiming2; Zhou, Lin2; Ma, Yu9; Zhu, Lizhen9; Gao, Weiwei9; Wang, Hongyuan1; Chen, Dafang1; Yang, Li1; He, Pingping1; Wu, Shanshan1; Tang, Shaowen1; Lv, Xiaozhen1; Shu, Zheng1; Zhang, Yuan1; Yang, Zhirong1; Chen, Yan10; Li, Na11; Sun, Feng1; Li, Xiaoting12; He, Yingjian12; Garner, Paul13; Zhan, Siyan1
刊名: PLOS ONE
发表日期: 2011-07-05
DOI: 10.1371/journal.pone.0021836
卷: 6, 期:7
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Multidisciplinary Sciences
研究领域[WOS]: Science & Technology - Other Topics
关键词[WOS]: INDUCED HEPATOTOXICITY ; INDUCED HEPATITIS ; TUBERCULOSIS ; PYRAZINAMIDE ; SUSCEPTIBILITY ; THERAPY
英文摘要:

Background: Anti-tuberculosis drug induced liver injury (ATLI) is emerging as a significant threat to tuberculosis control in China, though limited data is available about the burden of ATLI at population level. This study aimed to estimate the incidence of ATLI, to better understand its clinical features, and to evaluate its impact on anti-tuberculosis (TB) treatment in China.

Methodology/Principal Findings: In a population-based prospective study, we monitored 4,304 TB patients receiving directly observed treatment strategy (DOTS) treatment, and found that 106 patients developed ATLI with a cumulative incidence of 2.55% (95% Confidence Interval [CI], 2.04%-3.06%). Nausea, vomiting and anorexia were the top three most frequently observed symptoms. There were 35 (33.02%) ATLI patients with no symptoms, including 8 with severe hepatotoxicity. Regarding the prognosis of ATLI, 84 cases (79.25%) recovered, 18 (16.98%) improved, 2 (1.89%) failed to respond to the treatment with continued elevation of serum alanine aminotransferase, and 2 (1.89%) died as result of ATLI. Of all the ATLI cases, 74 (69.81%) cases changed their anti-TB treatment, including 4 (3.77%) cases with medication administration change, 21 (19.81%) cases with drugs replacement, 54 (50.94%) cases with therapy interruption, and 12 (11.32%) cases who discontinued therapy. In terms of treatment outcomes, 53 (51.46%) cases had TB cured in time, 48 (46.60%) cases had therapy prolonged, and 2 (1.94%) cases died. Compared with non-ATLI patients, ATLI patients had a 9.25-fold (95% CI, 5.69-15.05) risk of unsuccessful anti-TB treatment outcomes and a 2.11-fold (95% CI, 1.23-3.60) risk of prolonged intensive treatment phase.

Conclusions/Significance: ATLI could considerably impact the outcomes of anti-TB treatment. Given the incidence of ATLI and the size of TB population in China, the negative impact is substantial. Therefore, more research and efforts are warranted in order to enhance the diagnosis and the prevention of ATLI.

语种: 英语
所属项目编号: NO:TB07-030
项目资助者: China Program for the Global Fund
WOS记录号: WOS:000292512000027
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/54574
Appears in Collections:北京大学公共卫生学院_期刊论文

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作者单位: 1.Peking Univ, Hlth Sci Ctr, Sch Publ Hlth, Dept Epidemiol & Biostat, Beijing 100871, Peoples R China
2.Chinese Ctr Dis Control & Prevent, Ctr TB Control & Prevent, Beijing, Peoples R China
3.Ctr Dis Control & Prevent Guangxi Zhuang Autonomo, Nanning, Peoples R China
4.Ctr Dis Control & Prevent Zhejiang Prov, Hangzhou, Zhejiang, Peoples R China
5.Ctr Dis Control & Prevent Jilin Prov, Changchun, Peoples R China
6.Ctr Dis Control & Prevent Chongqing Municipal, Chongqing, Peoples R China
7.Beijing Inst TB Control, Beijing, Peoples R China
8.State Food & Drug Adm, Ctr Drug Reassessment, Beijing, Peoples R China
9.Beijing TB & Thorac Tumor Res Inst, Beijing, Peoples R China
10.Indiana Univ, Sch Med, Dept Publ Hlth, Indianapolis, IN USA
11.Ctr Dis Control & Prevent Fangshan Dist, Beijing, Peoples R China
12.Beijing Inst Canc Res, Beijing, Peoples R China
13.Univ Liverpool, Liverpool Sch Trop Med, Int Hlth Grp, Liverpool L3 5QA, Merseyside, England

Recommended Citation:
Shang, Penghui,Xia, Yinyin,Liu, Feiying,et al. Incidence, Clinical Features and Impact on Anti-Tuberculosis Treatment of Anti-Tuberculosis Drug Induced Liver Injury (ATLI) in China[J]. PLOS ONE,2011,6(7).
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